Management of sepsis: early resuscitation.
Key links in the chain of survival for the management of severe sepsis and septic shock are early identification and comprehensive resuscitation of high-risk patients. Multiple studies have shown that the first 6 hours of early sepsis management are especially important from a diagnostic, pathogenic, and therapeutic perspective, and that steps taken during this period can have a significant impact on outcome. The recognition of this critical time period and the robust outcome benefit realized in previous studies provides the rationale for adopting early resuscitation as a distinct intervention. Sepsis joins trauma, stroke, and acute myocardial infarction in having "golden hours," representing a critical opportunity early on in the course of disease for actions that offer the most benefit.
Rivers
Emanuel P
EP
Department of Emergency Medicine, Henry Ford Health Systems, 270-Clara Ford Pavilion, 2799 West Grand Boulevard, Detroit, MI 48202, USA. erivers1@hfhs.org
Coba
Victor
V
Visbal
Alvaro
A
Whitmill
Melissa
M
Amponsah
David
D
D002116:Calcitonin / Q000097:blood; D003422:Critical Care; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D009102:Multiple Organ Failure / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood; D012151:Resuscitation / Q000379:methods*; D018805:Sepsis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D012772:Shock, Septic / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015996:Survival Rate; D014336:Troponin / Q000097:blood
D011498:Protein Precursors; D014336:Troponin; D020097:Natriuretic Peptide, Brain; D019344:Lactic Acid; D002116:Calcitonin